Insurance reform measures aimed at increasing health coverage picked up steam in Congress last week as a Senate plan earned the endorsement of a dozen provider and consumer groups and a House panel gave its blessing to a separate reform bill.
The House Economic and Educational Opportunities Committee passed a bill sponsored by Rep. Harris Fawell (R-Ill.) that would allow small employers to join together in federally regulated health insurance purchasing pools and permit workers to carry existing group coverage to new group plans.
Meanwhile, the Senate bill, sponsored by Labor and Human Resources Committee Chairwoman Nancy Kassebaum (R-Kan.) and Sen. Edward Kennedy (D-Mass.), picked up support from the American Hospital Association, the American Association of Health Plans, the American Medical Association and a number of other groups. The Senate will begin debate on the plan on April 18, Kassebaum announced last week.
The 24-18 committee vote passing the House bill came despite Democratic objections that the bill didn't go far enough to increase coverage by enabling workers to continue health coverage after they leave a job or are laid off.
Unlike the Kassebaum-Kennedy bill, the House measure doesn't allow workers to carry their group coverage into the individual market but only to continue it when joining a new group plan. Workers could not be denied coverage for a pre-existing condition when joining a new group plan if both their new group and old group plans covered it.
In committee, Democrats attempted to substitute the Kassebaum-Kennedy measure for Fawell's bill. They were defeated when Chairman William Goodling (R-Pa.) ruled that some of its provisions were not in the committee's jurisdiction. Later, Democratic leaders released a letter of support for the Kassebaum-Kennedy plan signed by more than 170 House Democrats.
Republican House leaders confirmed last week that they intend to meld the Fawell bill with a plan introduced by House Ways and Means health subcommittee Chairman Bill Thomas (R-Calif.). The Thomas plan also aims to make insurance more available and to eliminate pre-existing condition requirements for those who have had employer-sponsored insurance.
Rep. Dennis Hastert (R-Ill.), chairman of a GOP healthcare reform task force, said the leadership also is working on a provision acceptable to insurers that would allow workers to carry group coverage into the individual market.
Other provisions that GOP leaders said were candidates to be added to the health insurance plan include:
A limited malpractice reform package that would set caps on punitive damage awards and reduce hospitals' "deep pocket" liability.
Antitrust reform that would allow hospitals jointly to purchase high-tech equipment.
Allowing non-Medicare beneficiaries to enroll in medical savings accounts.
Raising the amount self-employed individuals can deduct for health insurance from 30% to 50%.
Democrats accused Republicans of using a vote on the Fawell bill as an election-year gambit. The Republicans wanted to look as if they took steps to reduce the uninsured population while simultaneously overloading the bill with enough controversial amendments so that neither the Senate nor President Clinton would endorse it, Democrats charged.
That appeared to be a very real possibility in the Senate. Leaders of both parties agreed not to support any amendments to the Kassebaum-Kennedy plans and added that they would not agree to the additional House-added items.